A Patient with Hinman's Syndrome who Underwent Renal Transplantation Using a Pre-existing Cutaneous Ureterostomy / 대한비뇨기과학회지

It is known that many renal transplantation candidates with end stage renal disease have bladder dysfunction. Before 1966, these patients were considered poor candidates for renal transplantation because of their many bladder problems. But it has recently been reported that renal transplantation with an ileal conduit could solve these problems. Herein, we report on a patient with Hinman's syndrome and this patient underwent renal transplantation using a pre-existing cutaneous ureterostomy.

The Suppressive Effect of Lentinus Edodes on Renal Scarring Secondary to Pyelonephritis / 대한비뇨기과학회지

PURPOSE: Lentinus edodes is used in both foods and drugs, and is also known to be an antioxidant agent. Some investigators have noted that renal scarring following pyelonephritis is closely related to inflammation or free oxygen radicals, rather than to direct injury due to bacterial infection. The efficiency of the antioxidant agent, lentinus edodes, in preventing the renal scarring caused by experimental pyelonephritis was evaluated in rats. MATERIALS AND METHODS: Twenty eight male Sprague Dawley rats (n=28) were injected into both renal parenchyma with 0.1ml of a solution containing Escherichia coli (10(8)/ml). The control group, consisting of 4 rats, received an injection of isotonic saline instead of the bacterial solution. Three days after surgery, the animals were given the following treatments: in the pyelonephritis group, 7 rats received isotonic saline for 5 days; in the antibiotics treatment group, 6 rats were treated with an antibiotic only, ciprofloxacin, for 5 days. In the lentinus edodes treatment group, 5 rats were treated with lentinus edodes only. In the combined group, 6 rats received both lentinus edodes and ciprofloxacin. The kidneys were harvested 6 weeks after infection, and histopathologically examined for renal scarring. RESULTS: Delayed treatment with antibiotics-only or lentinus edodes-only had no effect on the scarring compared with the untreated controls. However, the addition of lentinus edodes to the delayed antibiotic therapy significantly inhibited the renal scarring compared with the pyelonephritis, antibiotic-only treated and the lentinus edodes-only treated groups (p<0.05). CONCLUSIONS: The administration of lentinus edodes in combination with antibiotics significantly reduced the renal scar formation in pyelonephritis.

The Effect of Ring-type NF-kappa B(NF-kB) Decoy Oligodeoxynucleotide on the Kidney for an Experimental Unilateral Ureteral Obstruction in Mice / 대한비뇨기과학회지

PURPOSE: The transcription factor, NF-kB, is important in the coordinated expressions of various pro-inflammatory and adhesion molecules. Our hypothesis is that inhibiting the action of NF-kB using a synthetic decoy oligodeoxynucleotide(ODN) can block the underlying inflammatory response in glomerulonephritis. MATERIALS AND METHODS: Forty two male C57BL6 mice, weighting 25g, were divided into four groups; in group 1, 2 mice were used as normal controls; in group 2, a unilateral ureteral obstruction(UUO) was induced in 12 mice; in group 3, 20 UUO mice were treated using ring-type NK-kB decoy ODN; and in group 4, 8 UUO mice were treated using scramble type NF-kB decoy ODN. The mice were killed 1, 3, 5 and 7 days after the NF-kB decoy ODN injections, and the blood urea nitrogen(BUN), and expressions of tumor necrosis factor-alpha (TNF-alpha), interleukin-beta(IL-beta), fibronectin, vascular cell adhesion molecule(VCAM) and monocyte chemotactic protein-1(MCP-1), as well as the histopathological findings, analyzed in each group. RESULTS: The serum levels of BUN, TNF-alpha, IL-beta, fibronectin, VCAM and MCP-1 were increased in group 2, but decreased in group 3. The histopathological findings of the kidneys in group 3 were most similar to those found in the control(group 1). CONCLUSIONS: NF-kB decoy ODN treatment substantially inhibited the disease, with reductions in the histological damage and the renal expressions of inflammatory cytokines.

The Value of Diagnostic Laparoscopy for Impalpable Testes

There have been no definitive preoperative diagnostic imaging studies for impalpable testes. We observed the effectiveness of laparoscopy for detecting impalpable testes not identified with ultrasonography (USG) or careful physical examination under general anesthesia. We retrospectively reviewed 117 patients (118 testes) who were operated upon for undescended testes from January 1998 to December 2004. The testes of these patients were palpable in 97(82 %) and impalpable in 21 (18 %). We analyzed the preoperative diagnostic method, site of the testes, operative method and operative findings of the 21 impalpable testes. Preoperative USG and physical examination under general anesthesia were performed on 20 patients, and 12 patients' testes could be localized. Eight patients whose testes could not be localized with USG and physical examination underwent laparoscopy. Seven of the 8 patients had testes in inguinal canal and 4 of these were atrophied and underwent orchiectomy because of atrophy (2) and vanishing (2). Only 1 patient had bilateral intraabdominal testes and one of the testes was atrophied. Laparoscopy was a useful method for detecting impalpable testes, but the clinical application might be limited because the location of atrophic or vanishing testes was mainly inferior to internal inguinal ring.

Tuberculous Vesicovaginal Fistula / 대한비뇨기과학회지

The main cause of vesicovaginal fistula is gynecologic or obstetric manipulation, but vesicovaginal fistula as a complication of genitourinary tuberculosis is extremely rare. The diagnosis is confirmed by the histological findings, and treatment is surgical repair with antituberculous medication. We report here on the presentation and management of extensive tuberculosis that led to formation of a vesicovaginal fistula in an adult.